pet scans in patients with head and neck cancer who are undergoing 3-dimensional conformal radiation therapy and intensity-modulated radiation therapy

Conditions: Head and Neck Cancer

Summary: rationale: imaging procedures, such as pet scans, may determine the extent of cancer and help doctors plan radiation therapy. radiation therapy uses high-energy x-rays to kill tumor cells. giving radiation therapy that uses a 3-dimensional image of the tumor to help focus thin beams of radiation directly on the tumor, and giving radiation therapy in higher doses over a shorter period of time, may kill more tumor cells and have fewer side effects. specialized radiation therapy that delivers a high dose of radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. purpose: this clinical trial is studying pet scans to see how well they work in patients with head and neck cancer who are undergoing 3-dimensional conformal radiation therapy and intensity-modulated radiation therapy.

objectives: primary * to assess the value of pre-treatment pet in determining the target volume in patients with head and neck cancer undergoing three-dimensional conformational radiotherapy and intensity-modulated radiotherapy. secondary * to evaluate variations in weekly fludeoxyglucose f 18 pet imaging during the first 5 weeks of treatment. * to determine the relationship between changes in tumor metabolism during radiotherapy and control tumor at 3 months and at 1 year post-treatment. outline: this is a multicenter study. patients undergo fludeoxyglucose f18 pet (fdg-pet) in addition to conventional imaging at baseline. patients undergo standard three-dimensional conformational radiotherapy and intensity-modulated radiation therapy 5 days a week for 5 weeks. some patients also undergo weekly fdg-pet during treatment.

Eligibility criteria:
disease characteristics: * histologically confirmed head and neck cancer * no nasopharyngeal or paranasal sinus cancer * locally advanced disease (t3 or t4) * not in complete remission * planning to undergo curative radiotherapy (minimum dose of 66 gy), with or without standard treatment (i.e., platinum-based chemotherapy or biological therapy/rituximab) * measurable tumor according to recist criteria patient characteristics: * who performance status 0-2 * not pregnant or nursing * able to lie still for 1 hour * no history of progressive neoplastic disease * no known hypersensitivity to fludeoxyglucose f18 or any of its excipients * no severe or uncontrolled systemic disease, including any of the following: * kidney disease * liver disease * cardiac disease * unstable or uncompensated respiration * uncontrolled diabetes (i.e., glucose ≥ 1.5 g/l) * no geographical, social, or psychological conditions that make follow-up impossible prior concurrent therapy: * see disease characteristics * no prior surgery * no concurrent experimental agents

Keywords: recurrent squamous cell carcinoma of the hypopharynx stage iii squamous cell carcinoma of the hypopharynx stage iv squamous cell carcinoma of the hypopharynx recurrent squamous cell carcinoma of the larynx stage iii squamous cell carcinoma of the larynx stage iv squamous cell carcinoma of the larynx recurrent verrucous carcinoma of the larynx stage iii verrucous carcinoma of the larynx stage iv verrucous carcinoma of the larynx recurrent adenoid cystic carcinoma of the oral cavity recurrent mucoepidermoid carcinoma of the oral cavity recurrent verrucous carcinoma of the oral cavity stage iii adenoid cystic carcinoma of the oral cavity stage iii mucoepidermoid carcinoma of the oral cavity stage iii verrucous carcinoma of the oral cavity stage iv adenoid cystic carcinoma of the oral cavity stage iv mucoepidermoid carcinoma of the oral cavity stage iv verrucous carcinoma of the oral cavity recurrent basal cell carcinoma of the lip recurrent squamous cell carcinoma of the lip and oral cavity stage iii basal cell carcinoma of the lip stage iii squamous cell carcinoma of the lip and oral cavity stage iv basal cell carcinoma of the lip stage iv squamous cell carcinoma of the lip and oral cavity metastatic squamous neck cancer with occult primary squamous cell carcinoma recurrent metastatic squamous neck cancer with occult primary untreated metastatic squamous neck cancer with occult primary recurrent lymphoepithelioma of the oropharynx recurrent squamous cell carcinoma of the oropharynx stage iii lymphoepithelioma of the oropharynx stage iii squamous cell carcinoma of the oropharynx stage iv lymphoepithelioma of the oropharynx stage iv squamous cell carcinoma of the oropharynx high-grade salivary gland mucoepidermoid carcinoma low-grade salivary gland mucoepidermoid carcinoma recurrent salivary gland cancer salivary gland acinic cell tumor salivary gland adenocarcinoma salivary gland adenoid cystic carcinoma salivary gland anaplastic carcinoma salivary gland malignant mixed cell type tumor salivary gland poorly differentiated carcinoma salivary gland squamous cell carcinoma stage iii salivary gland cancer stage iv salivary gland cancer